HTH Blog

HomeTown and USAToday article – thanks for your many comments – See below how the article was developed and made

November 20th, 2014

USA Today Article on Critical Condition of rural hospitals – Thank you Jayne O’Donnell

Be sure to click on Video link on chapter one – great video!!!!


Thank you for the many compliments and conversations regarding the recent USAToday article on rural hospitals and with HomeTown quoted. The article has received incredible national recognition and has been repeated by other news associations all over the nation. It also has been picked up by Fox News and especially “the Five “ with Greg Gutfeld. Many of you have asked how did this occur and how and who was included in the article development and why.



  1. USAToday has the greatest distortion in the US according to some sources
  2. If dire circumstances are to change the national public has to be made aware of the magnitude of the problem
  3. This was not ever portrayed by either party to be a confrontational investigation but rather a human interest story that is playing out over the united states
  4. 43 rural hospitals have already closed recently in the US thus underscoring the need for exposure and illumination
  5. HomeTown Health represents only rural hospitals thus does not have to get approval from urban members to “OK “ Involvement
  6. HomeTown has just recently conducted 33 hospital visits since June 2014 and listed to 33 hospital presentations on the dire situation of rural hospitals
  7. Because HomeTown has 7000 enrollees in it education program and conducted over 100 webinars , HomeTown has a more in depth understanding of the rural hospital situation than others.
  8. With the depth of knowledge of the rural problems, HomeTown can get “down in the weeds” to discuss the real cause of the problems
  9. Because HomeTown has the press savvy to deal with news people of this stature, the news people are more open to spending three days in traveling and discussion about the problem


                The article’s development story goes like this:


  1. In mid August HomeTown received a call from Jayne O’Donnell, health care reporter for USA Today, indicating that she had heard of the rural hospital dilemmas and especially in Georgia. She wanted to do a story and ask if we could help. Again, Jayne O’Donnell is the Health Care Reporter for USAToday who does many front page exposure articles.
  2. Yes and with HomeTown’s help she made a number of inquires indicating that she would like to come to Georgia and see for herself and talk to people about the problems of closed hospitals pointing out that the article would appear in USAToday and its national distribution
  3. She proposed to conduct a visit in mid September for which HomeTown then proposed and agreed to help her as a resource to produce the article with visits and contacts
  4. This resulted in a three day plan to visit Georgia ranging from Monday September 29 – Wednesday October 1
  5. In the meantime HomeTown began developing a travel schedule and contacts and sites to visit for her. All of which were received enthusiastically
  6. Her visits included
    1. Monday September 29 travel to Atlanta and travel on her own for background for Georgia many hospital closures
    2. Tuesday HomeTown arranged for her to travel to visit three hospital CEO’s and discusses their hospital issues (schedule below)
      1. The Four hospitals were chosen because of their major problems as have been publicized extensively
        1. Elbert Memorial Hospital –
        2. Ty Cobb Health System –
        3. Earl Whitely for Calhoun Memorial Hospitals –
        4. Stewart Webster Hospital – Randy Stigleman and Sybil Ammons
      2. These hospitals were chosen because Jayne wanted to hear the real problems and issues ranging from closure to major finance distress to struggling near closure and what caused the problems
      3. The four hospital CEO’s agreed to talk to her so HomeTown Health , with Jimmy Lewis and Jennie Price, traveled with her to the three hospitals beginning at 7 AM on Tuesday September 30 and going to 9:00 PM after about 300 miles traveled. Similarly as intense as the policymaker tours.
      4. Each CEO did a magnificent job of spelling out how bad the situation was and laying out how the hospital had gotten in so much trouble.
      5. Additionally , Elbert Memorial’s Jim Yarborough convinced his board to discuss their views of the problem and how their grass roots had worked to gain approval and passage of a $500,000 millage allocation for one year passage to help the hospital

Tuesday Sept 30

7:00 AM – 9:00 AM travel to Elberton – Jim Yarborough CEO Elbert Memorial

9:00 AM – 11:00 AM conversation with community leaders Elberton

11:00 AM – 11:45 AM Drive to Lavonia – Ty Cobb conversation with leaders – Greg Hearn CEO Ty Cobb

11:45 AM – 1:45 PM Conversation with community leaders

1:45 PM – 3:30 PM Drive to Atlanta

3:30 PM – 5:30 PM conversation with Earl Whiteley who was CEO at closure of Calhoun County Hospital

      1. Then on Wednesday HomeTown had helped connect Jayne to the closed hospital scenario in Richland, Georgia where Stewart Webster Hospital had closed last year
      2. In the rural setting she wanted to talk with the community about the impact. Because HomeTown had worked extensively with the players during the tenure as members of HomeTown Health before they closed, we were able to get her in front of or on the phone with the key players cited in the article
      3. There were many hours of background research and discussion with many players for the rural community
    1. Her visit included follow-up visits with a photographer/videographers to record the picturesque and in some cases devastating results of a  hospital closing
    2. Upon going back to Washington DC where she is headquartered with USAToday, she spent much time creating the article until the publication of the article last weekend.
    3. Shared sites for the article (these are sites that picked up for reprint)
      1. USA Today as the origin
      2. Newsbusters –
      3. Health Leaders –
      4. Fox News – Townhall –
      5. Fox News –“The Five” – Greg GutFeld
      6. The Tennessean –;
    4. Indications are that the “share rate “of this article is higher than many recent news articles published
    5. There are indications of other future exposure from this article through other news exchanges

What was the purpose of the article?

  1. To illuminate the problem with so many rural hospitals closing
  2. To put the people side of the story out to the nation
  3. To illustrate the vacuum occurring when the employment and health center of a community goes away.

What was HomeTown’s mission in this article?

  1. To give a national spotlight to the very debilitating circumstance of loss of health care to rural Georgians in hopes of helping make a change to policy.


This was an incredible team effort developed solely for the illumination of the need for the preservation of rural health care in Georgia! Thanks to everyone involved! Thank you for allowing HomeTown Health to be your rural hospital and health care voice!           


Thank you Jayne O’Donnell!






Rural Hospital Stabilization committee – what was said and learned?

August 27th, 2014


The Georgia Rural Hospital Stabilization Committee met yesterday in Cordele.  A brief summary of the meeting is found in the Georgia Health News link found below:


Summarily the meeting covered the following subjects

  1. Attorney General
    1. 31 hospital transactions have occurred since October, 1997. All have been approved with no rejections
    2. The act is designed to insure that the community hospital  transaction is held in full transparency.
    3. There is no fairness opinion required
    4. The AG works closely with all parties to resolve any questions
    5. One big takeaway is that for any community contemplating such an action clearly it should notify the AG’s office first and early
    6. The attached presentation pretty well lays out the subject
    7. Major Point——


What if a hospital closes?

If a hospital closes and an acquisition occurs soon after closing, our office will closely scrutinize the transaction to determine whether the Act applies. Cannot close a hospital to avoid compliance with the Act.


  1. Draffin Tucker – Freestanding ER findings given their research
    1. Foremost there are two kinds of ER
      1. Hospital based free standing ER’s which are owned and operated by larger hospitals
        1. Operated as a division or department of larger hospital
        2. Mostly occur in Suburban areas
          1. To capture market share
      2. Totally Freestanding independent ER
        1. Original mission was for rural communities to prese
        2. Very few of these exist
        3. Wherever they exist it is usually in rural communities
        4. Only 14% of those surveyed are free standing independent ER’s
    2. Universal findings are that standalone ER’s as would be used in Georgia do not have reimbursement sustainability
    3. Regulations are very varied and can be extensive with EMTALA being a major constraint
    4. A 2008 New York study was cited that was very revealing regarding standalone FED’s this is very important to read as well. It tell the real story about FED’s – MUST READ EXCELLENT WHITE PAPER AND CMS REGULATIONS ON FED’s – Freestanding ED’s

  1. Map Overlay of health care access
    1. This was the highlight of the meeting in that it was a layering program where different types of health care access could be overlaid to show what is available where
    2. This did a great job of illustrating how prolific health care access is in Georgia but also how fragmented and independent the various missions and goals are the various types.
      1. Types included: hospitals(PPS and CAH), clinics, FQHC’s, EMS, Trauma, Urban rural to name few
  2. Other issues
    1. Committee member and Ty Cobb CEO Greg Hearn discussed at length the negative reimbursement impact upon rural hospitals and providers citing the state health benefit plan as a very difficult bad payor. He also pointed out that through a study that Ty Cobb had done that the payor mix cross subsidization was now so out of proportion that it would take commercial business paying over 300% of cost to compensate for underpayment of all other payors and that is not going to happen. But it is now compounded by the Blue Cross State Health Benefit Plan payment problems and service withdrawals such as labs, imaging, etc.
  3. The next committee meeting is set for November 20, 2014


Georgia Health News – offers a summary of the meeting



FROM ORHS and posted on DCH website

  2. Draffin Tucker – Charles Horne –
  3. Attorney General discussion of HB Acquisitions Act HB600 –
  4. Map of Health Care Providers – an overlay
    2. The Google Map works best using Google Chrome; you will have issues using Internet Explorer.  Once it loads, simply click the square box to the left of the provider type to populate the icons; you will see a check mark appear in the box.  You may add and remove layers by clicking the boxes to the left of the provider types.  There may be a few second delay depending your internet connection speed.  If you have challenges with it just give me a call, 229-401-3081.


Overall, there seems to be recognition that the rural health care dilemma is a very big and complex problem and is far greater than the FED fix that is being considered. You will be notified when Webx link is uploaded to DCH website.


Governor Deal names Rural Hospital Stabilization Committee members – J Lewis of HomeTown an appointee

April 28th, 2014



Fulfilling a commitment that he made during the just finished session, Governor Deal has established and named the appointees to the Rural Hospital Stabilization Committee. The charge of this committee will be to identify ways and means to stabilize the rural hospital and health care situation in Georgia. This is an excellent move in this dynamic and rapidly changing  health care environment! A great thank you to Governor Deal for this initiative. This is an exceptional committee of appointments. Rural hospitals have a prominent place on this committee as we see HomeTown Health, Ty Cobb Health Care, Liberty Regional, Community Health Systems, Tift Regional, and Fannin and also the high Medicaid provider in Memorial Health Care of Savannah who so diligently supports rural hospitals in its service area.

 Once again this now underscores that you as rural hospitals have a seat at the table!

 Please send “thank you’s” to Governor Deal for this committee establishment and let your state legislators know of your pleasure with this action!! See below Release:

From: Gov. Deal’s Communications Office <>

Sent: Friday, April 25, 2014 11:09 AM

To: Gov. Deal’s Communications Office

Subject: Deal names Rural Hospital Stabilization Committee members



For immediate release                                                                                                    Office of Communications

April 25, 2014                                                                                                                       (404) 651-7774


Deal names Rural Hospital Stabilization Committee members


Gov. Nathan Deal today announced his appointments to the Rural Hospital Stabilization Committee, which was created to identify needs of the rural hospital community and provide potential solutions.


“In March of this year, I proposed three revisions to the way we approach rural health care, with one being the Rural Hospital Stabilization Committee,” Deal said. “I recognize the critical need for hospital infrastructure in rural Georgia and remain committed to ensuring citizens throughout the state have the ability to receive the care that they need. This committee will work to increase the flow of communication between hospitals and the state and improve our citizens’ access to health care. I am proud to welcome this team and look forward to what we stand to accomplish.”


Committee members are listed below:


Name Organization Hometown
Jimmy Lewis HomeTown Health Cumming
Greg Hearn Ty Cobb Regional Medical Center Lavonia
Scott Kroell Liberty Regional Medical Center Hinesville
Maggie Gill Memorial Health Savannah
Wade Johnson Lincoln County Commission Chairman Lincolnton
Dr. Angela Highbaugh-Battle Pediatrician Hazlehurst
Charles Owens State Office of Rural Health Cordele
Sen. David Lucas Georgia Senate Macon
Rep. Terry England Georgia House of Representatives Auburn
Molly Howard Jefferson County Superintendent Louisville
Jimmy Allen Business Owner and Tift Regional Hospital Board Member Adel
Dr. Thomas Fitzgerald Tanner Medical Center, Emergency Medicine Carrollton
Ronnie Rollins Community Health Systems Macon
David Sanders Fannin Regional Hospital Blue Ridge
Dr. Jeffrey Harris- OB/GYN Jesup


Brian Robinson


Sasha Dlugolenski


Governor Deal speaks to HomeTown Annual Spring Meeting! Great event!

April 28th, 2014


In what was a momentous occasion for rural hospitals, Governor Nathan Deal spoke to the HomeTown Health Annual Spring Conference. Entering to a standing ovation for his support of rural hospitals, Governor Deal spoke of his commitment to rural hospitals and the stress that they are under due to the rapidly changing health care environment. Fulfilling his commitment during the session, Governor Deal announced his three pronged approach to helping rural hospitals and health care. Governor Deal named his Rural Hospital Stabilization Committee, a rural hospital liaison within DCH(Charles Owens), and his support for the stand alone ED language being considered by the DCH Board next week. Speaking to nearly 200 HomeTown Health Rural hospital and business partners affiliates , Governor Deal’s remarks were warmly received as many of the attending hospitals are benefactors of his recent help for them in their financial crisis.


A great thank you to the Governor and his staff and  to Commissioner  Reese who on Governor Deal’s behalf has been incredibly supportive of the rural hospitals.



Standalone rural ER’s face a serious hurdle – HomeTown offers testimony

April 17th, 2014

Standalone rural ER’s face a serious hurdle – HomeTown offers testimony

 ED Testimony on Language 04152014


DCH did at the end of the session promulgate standalone ER language from licensure and regulations in an attempt to create access to health care when/if a rural hospital closes. This came from the recent list of rural hospital closings. That language is attached.


DCH did hold a hearing on the subject yesterday. There was only one speaker and that was Jimmy Lewis, CEO of HomeTown Health. My testimony is attached . Basically what it says is that while this language is a good start down a long road it requires much fine tuning and adjustment. Please see the attached testimony as well as the news article as report by Georgia Health News. This will also be a subject of discussion at the spring meeting next week as well.



Also please read the attached article that covers the subject very well as well.


Tell us what you think! Your input is highly valuable!

HomeTown Spring Meeting Town Hall Meeting questions for discussions

April 11th, 2014

HomeTown Health CEO’s and Senior Staff :

Reference: Important!!HomeTown Spring Meeting Town Hall Meeting questions for discussions- response requested


HomeTown is preparing for the Town Hall Meeting to be held at the HomeTown Health Spring meeting in Savannah at Riverfront Marriot on April 24, 2014. This will be the 2 hour afternoon open floor session for the meeting that starts April 23 with the Board/Authority training session and ending Friday April 25 after Governor Deal has spoken.


In preparation for this 2 hour Town Hall Meeting, we have reached out for high priority questions that you want to discuss during this open forum event. Below and attached are a few questions that have been raised for that discussion. By means of this email we are soliciting any other question that you want addresses. Early next week then we will send you a priority survey by which the order of priority will be set to discuss these during that Town Hall Meeting.

HomeTown Health Town Hall Questions

Spring Meeting April 24, 2014

  1. What is impact of State Health Benefit Plan conversion to Blue Cross in revenue lost thus far in 2014 by hospitals?
  2. What are hospitals doing to offset loss of revenues due to Blue Cross off loading labs, imaging, and therapy and day surgery where possible to ambulatory surgery or stand alone centers?
  3. What is impact of postponing ICD10 on hospital and physicians?
  4. What is any hospital doing about Hospital Readmissions?
  5. Describe the use and effectiveness of PA’s and Midlevel’s?
  6. How effective are hospitalist programs?
  7. What is a hospitalist hybrid program?
  8. Has anyone had Health Insurance Exchange patients show up in ER or in business office?
  9. Has anyone figured out to handle Health Insurance Exchange subsidies?
  10. Discuss the proposed Authority/Board education that HomeTown started yesterday.
  11. When will DSH and UPL pay?
  12. What is the discussion of reopening the Provider Fee about as a result of the Tier 2 problems?


Tell us what you think by responding to this email! Your input is highly valuable! Please send any additional questions return via email so we can include them in the planning process. If you have not registered for the meeting and, some 200 have already, please do so now.





Governor Deal Embraces rule changes to help rural hospitals when downsizing is needed – a great move!

March 20th, 2014

The Rural Hospital crisis in Georgia has now been given front and center attention. You as rural hospitals have a seat at table. Governor Deal has personally been involved in helping a number of rural hospitals in various crisis modes , the least of which is this announcement. This will allow the greater debate of the new model of health care  in rural Georgia to gain momentum. It is great news and Governor Deal  is to be commended for this major initiative.

More details will follow in the coming days! Governor Deal will be speaking at the HomeTown Health Spring Conference in April. That will be a great time to hear his comments!

 Georgia Health News


Macon Telegraph




AJC writes:

Rule rewrite aims to help rural hospitals

Deal’s plan would let underfunded facilities drop costly services.

By Greg Bluestein

   Spooked by a spate of recent hospital closings in rural Georgia, state leaders on Wednesday embraced a rewrite of health care rules aimed at keeping faltering facilities open.

   Gov. Nathan Deal’s plan would allow rural hospitals to dramatically scale back their services if they are in danger of closing or if they’ve shut their doors in the last year. The goal is keep these health care facilities afloat as they struggle for funding amid high unemployment rates and stagnant population growth in struggling areas.

   The changes only apply to facilities within 35 miles of a full-service hospital. They would be allowed to convert into a freestanding emergency room that can stabilize patients and transfer them to nearby full-service hospitals. The changes allow them to abandon other costly staples of hospital care, such as inpatient surgery and complicated child deliveries.

   “Communities should not have to go without crucial services — many of them life-saving — simply because they don’t fall within a certain ZIP code,” said Deal, adding: “By eliminating the necessity of trying to staff a full-service hospital with beds that do not have patients, with staff they do not necessarily need, I think this will help hospitals to stay open.”

   The plan earned bipartisan support from rural lawmakers and health care advocates. Yet several legislators warned that a more sweeping fix is needed to help sustain rural hospitals in the longer term, and contended that Deal’s decision to reject funding for Medicaid expansion under the federal health care overhaul only aggravated the situation.

   “I see it as a good step in the right direction,” said state Rep. Debbie Buckner, D-Junction City. “A lot of what rural hospitals need is a steady cash flow. And I don’t know if these suggestions will lead to that.”

   The fate of rural hospitals is a recurring theme this legislative session, which ends today. Four rural hospitals were shut down over the last two years, and four others have closed their doors since 2000. Health care activists worry more could be shuttered because of Deal’s rejection of the Medicaid expansion , which he views as too costly.

   Republican state Rep. Sharon Cooper of Marietta revived the debate over how to bolster faltering rural hospitals in January when she said that some need to close and instead rely on regional hubs. She walked back those comments after fierce backlash, but her remarks underscored the ongoing struggle over how to bolster rural hospitals.

   Deal’s critics see a ready-made solution to the problems. They contend that expanding Medicaid under President Barack Obama’s health care overhaul would add an estimated 650,000 low-income Georgians to the program’s rolls and a wave of new revenue for the hospitals.

   “His plan is not even a small Band-Aid for a health care crisis that threatens the lives millions of Georgians,” said Bryan Long of Better Georgia, a progressive group that often needles the governor. “Cutting services in areas that are already suffering and creating a committee for simply more talk is insulting to the families who depend on these rural hospitals.”

   Deal has made clear that expanding Medicaid in the state is a nonstarter, and his office estimates it could cost the state $2.5 billion over a decade even with the federal government’s promise to pick up 90 percent of the tab after three years. He argued Wednesday that expanding Medicaid would not help rural hospitals because it’s a “cost-loser” that wouldn’t fund the full cost of medical services.

   Rural hospitals that have already shuttered left behind devastated communities. Stewart-Webster Hospital in Richland closed last year after seeing only about 10 patients a day and about five surgeries a week. Patients who live in the southwest Georgia community are being diverted to larger hospitals in Columbus and Americus, both about 35 miles away.

   Bonnie Witt, a county clerk who lives in Richland, remembers cutting her hand after a nasty fall about six years ago. Her terrified husband bundled her into the family car, hopped the curb outside the facility and rushed her inside to get stitches.

   “I thought I was going to die. If I had to go anywhere besides Richland that day, I don’t know what I would have done,” said Witt, a 56-year-old who was born and raised in the community.

   “I was going to that hospital all my life. It hurt us really bad when it closed. And I miss it. Everyone does,” she said.

   State Rep. Terry England, who advised Deal on the plan he unveiled Wednesday, said shuttered hospitals give potential employers a reason to go elsewhere.

   “If companies come to look at rural Georgia, they look at access to rural health care for their employees,” said England, an Auburn Republican who chairs the House’s budget-writing committee. “And you take those rural hospitals out of the mix, that has a crippling effect on those local communities in attracting industry. It’s not a deal-breaker, but it’s important for quality of life.”

   The governor will also assign a state health employee to serve as liaison to rural hospitals who will alert the state if any are in danger of closing. And he’ll tap a committee to come up with legislative recommendations aimed at rural hospitals. The plan doesn’t require legislation, and it is expected to be approved by the Department of Community Health soon.

   Some Democrats and advocates hold out fleeting hope that Republican leaders have a change of heart over the Medicaid expansion, despite anti-Obamacare laws approved in the session’s final days aimed at snubbing the federal overhaul.

   “Anything we can do to keep that cash flow where it is will help,” said Buckner, the Democratic lawmaker. “I believe that Medicaid expansion would help kick the can down the road and infuse cash to keep those hospitals going. It may not be the solution, but it would help in the short term while we come up with a long-term fix.”

March 19th, 2014

 HomeTown Tells the rural story to Georgia Public Broadcasting

 Recently, HomeTown Health was invited to attend a panel discussion on Georgia Public Broadcasting about the crisis of rural hospitals in George. The interview was hosted by Bobbie Battista formerly of CNN and Bill Nigut formerly of WSB TV Atlanta and both now with Georgia Public Broadcasting. The segment is titled “On The Story”.

The program dealt with the closure of one hospital , the personal trials as a result  of that, a discussion of the causes of the problems  with rural health care, and telemedicine and Stabilization centers as sponsored by Senator David Lucas as an alternative. This was an excellent discussion and certainly would be good board education as well as staff education. It illustrates how important for your as rural hospital to have a seat at the table where your story can be heard!

 A video—please watch – start at 6:18 minutes into script



Tell us what you think by responding to this email! Did we tell your story well? Your input is highly valuable!

March 19th, 2014

HomeTown Health Spring Meeting – April 23-25- GOVERNOR DEAL IS SPEAKING!!!

 What better conference to attend than the 2014 HomeTown Health Annual Spring Conference in Savannah Georgia

  1. Governor Deal is coming and speaking to the group
  3. There will be a special  Board of Directors seminar to address many board issues and liabilities on April 23
  4. There will be the most current updates on the ACA and what the implications are for this on your hospitals
  5. You will hear motivation from Disney!
  6. You will hear first hand solutions to the most pressing hospital problems from hands on practitioners from within hospitals
  7. AND


Please see the agenda and get in on the early bird registration. Remember it only takes one small piece of critical information to give a hospital a positive boost. Come to Savannah to get that piece of information!!!


Register by March 22nd for Early Bird Registration Rate!!

How did the Georgia Rural Hospital industry get in this problem – an interview with Health Leaders Media a national health journal.

February 21st, 2014

HomeTown was invited to do an interview with Health Leaders Media. This is a nationally renowned health care trade blog and news letter. The interviewer, John Commins – a senior editor with Health Leaders, wanted to know how bad the Georgia situation is and  how it got there. The interview is presented from a transcript of the interview in this link that went nationwide.

 It is critical that the word get out as to how bad the Georgia rural hospital situation is and what may be done to help it. This is an attempt to frame the issue. HomeTown can explain the situation best because its membership is mutually compatible in that they are all small and rural hospitals and we are in those hospitals  hands on a daily basis helping solve survival problems. This is evidenced by the fact that HomeTown has been in nearly a dozen hospitals helping solve major survival issues in the last 8 weeks since Christmas 2013. This is  in a addition to the closure of one hospital.

 This is an excellent piece for your Hospital Board and County Commission education. Please share it with them!

 Who is Health Leaders? See Below.